<TITLE>
<STUDY NUMBER>
ADDENDUM TO THE CONSENT
FOR ALL PARTICIPANTS
As indicated in the initial Informed Consent, all participants will be informed of any
changes in the research protocol during the course of the trial. This study now includes
<CHANGES>.
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I was given the opportunity to ask questions about this change and was given sufficient
time to consider my continued participation. I have received a copy of this addendum
to the consent and agree to continue to participate.
Name of Participant (please print)
Participant’s Signature
Date
Signature of Person Conducting
the Informed Consent Discussion
Date